Independência funcional, aspectos clínicos e fatores sociodemográficos em pacientes na fase aguda do Acidente Vascular Cerebral: uma análise de associação
Functional independence, clinical aspects, and sociodemographic factors in patients in the acute phase of stroke: an association analysis
Thaline Moura de Oliveira; Stela Maris Aguiar Lemos; Antônio Lúcio Teixeira; Marcela Aline Braga; Aline Mansueto Mourão
Resumo
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Abstract
Purpose: To analyze the association of functional independence with clinical aspects of neurological impairment, the location and extent of neuronal damage and sociodemographic factors in patients in the acute phase of stroke.
Methods: Analytical cross-sectional study in 90 adult and older patients affected by ischemic stroke, admitted to the hospital within 24 hours of the vascular event. Sociodemographic factors and clinical aspects data were collected from electronic medical records and/or interviews in order to depict the patients'profile, Oxfordshire Community Stroke Project, Alberta Stroke Programme Early CT Score, National Institute of Health Stroke Scale, and Functional Independence Measure.
Results: Neurological impairment, according to the National Institute of Health Stroke Scale, was associated with functioning in the first 24 hours after the stroke. Furthermore, the presence of arterial hypertension, age, inactive work, smoking and extent of neuronal damage were associated with functional dependence, but did not remain in the final model of this study.
Conclusion: Functional dependence is associated with arterial hypertension, age, inactive work, smoking, extent of neuronal damage, and degree of neurological impairment in the first 24 hours after the vascular event. Furthermore, a higher level of neurological impairment was independently associated with increased levels of functional dependence.
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Referências
1 Estrela TLRS, Assis SC, Daltro MCSL. Avaliação da funcionalidade de pacientes com sequelas de acidente vascular cerebral através da escala de Rankin. FisioterBras. 2018;19(5, Supl):S192-9.
2 Bitencourt TC, Santos FMK, Soares AV. Relação entre a funcionalidade e a capacidade motora de pacientes pós-AVC na fase aguda. Rev Neurocienc. 2020;28:1-18.
3 Bettger JP, Thomas L, Liang L, Xian Y, Bushnell CD, Saver JL, et al. Hospital variation in functional recovery after Stroke. Circ Cardiovasc Qual Outcomes. 2017;10(1):e002391.
4 Donkor ES. Stroke in the 21st century: a snapshot of the burden, epidemiology, and quality of life. H Stroke Res Treat. 2018;20:3238165.
5 Prodinger B, O’Connor RJ, Stucki G, Tennant A. Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel index, utilizing the International Classification of Functioning, Disability and Health and Rasch measurement theory. J Rehabil Med. 2017;49(5):416-22.
6 Rayegani SM, Raeissadat SA, Alikhani E, Bayat M, Bahrami MH, Karimzadeh A. Evaluation of complete functional status of patients with stroke by Functional Independence Measure scale on admission, discharge, and six months poststroke. Iran J Neurol. 2016;15(4):202-8. PMid:28435628.
7 Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019 Dez;50(12):e344-418.
8 Campos TF, Dantas AATSG, Melo LP, Oliveira DC. Grau neurológico e funcionalidade de pacientes crônicos com acidente vascular cerebral: implicações para a prática clínica. Arq Cienc Saúde. 2014;21(1):28-33.
9 Kimura T. The items and level contributing to improve in less than 50 motor functional independence measure upon admission in the stroke recovery rehabilitation ward. J Phys Ther Sci. 2019;31(5):418-23.
10 Araújo LS, Assis SC, Belchior ACS. Avaliação da funcionalidade de pacientes com sequelas de acidente vascular cerebral por meio da escala MIF. Fisioter Bras. 2018;19(5, Supl Supl):S208-17.
11 Costa FA, Silva DLA, Rocha VM. Severidade clínica e funcionalidade de pacientes hemiplégicos pós-AVC agudo atendidos nos serviços públicos de fisioterapia de Natal (RN). Cien Saude Colet. 2011;16(Supl Supl. 1):1341-8.
12 Brasil. Ministério da Saúde. Portaria n° 665, de 12 de abril de 2012. Dispõe sobre os critérios de habilitação dos estabelecimentos hospitalares como Centro de Atendimento de Urgência aos pacientes com Acidente Vascular Cerebral (AVC), no âmbito do Sistema Único de Saúde (SUS), institui o respectivo incentivo financeiro e aprova a Linha de Cuidados em AVC. Diário Oficial da União; Brasília; 12 abr. 2012.
13 Muniz ECS, Thomaz MCA, Kubota MY, Cianci L, Souza RMCS. Utilização da escala de coma de Glasgow e escala de coma de Jouvet para avaliação do nível de consciência. Rev Esc Enferm USP. 1997 Ago;31(2):287-303.
14 Fabbri RMA, Moreira MA, Garrido R, Almeida OP. Validity and reliability of the Portuguese version of the confusion assessment method (CAM) for the detection of delirium in the elderly. Arq Neuropsiquiatr. 2001;59(2-A):175-9.
15 Pittock SJ, Meldrum D, Hardiman O, Thornton J, Brennan P, Moroney JT. The Oxfordshire Community Stroke Project Classification: correlation with imaging, associated complications, and prediction of outcome in acute ischemic stroke. J Stroke Cerebrovasc Dis. 2003 Jan;12(1):1-7.
16 Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. Lancet. 2000 Maio;355(9216):1670-4.
17 Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989 Jul;20(7):864-70.
18 Riberto M, Miyazaki MH, Jorge D Fo, Sakamoto H, Battistella LR. Reprodutibilidade da versão brasileira da Medida de Independência Funcional. Acta Fisiátrica. 2001;8(1):45-52.
19 Riberto M, Miyazaki MH, Jucá SSH, Sakamoto H, Pinto PPN, Battistella LR. Validação da versão brasileira da medida de independência funcional. Acta FisiatR. 2004;11(2):72-6.
20 Assis CS, Batista LC, Wolosker N, Zerati AE, Silva RCG. Functional independence measure in patients with intermittent claudication. Rev Esc Enferm USP. 2015;49(5):756-8.
21 Roy-O’Reilly M, McCullough LD. Age and sex are critical factors in ischemic stroke pathology. Endocrinology. 2018 Ago;159(8):3120-31.
22 Ghoshchi SG, Angelis S, Morone G, et al. Return to work and quality of life after stroke in Italy: a study on the efficacy of technologically assisted neurorehabilitation. Int J Environ Res Public Health. 2020;17(14):5233.
23 Radford KA, Craven K, McLellan V, Sach TH, Brindle R, Holloway I, et al. An individually randomised controlled multi-centre pragmatic trial with embedded economic and process evaluations of early vocational rehabilitation compared with usual care for stroke survivors: study protocol for the RETurn to work After stroKE (RETAKE) trial. Trials. 2020;21(1):1010.
24 Pan B, Jin X, Jun L, Qiu S, Zheng Q, Pan M. The relationship between smoking and stroke: a meta-analysis. Medicine. 2019;98(12):e14872.
25 Cipolla MJ, Liebeskind DS, Chan SL. The importance of comorbidities in ischemic stroke: impact of hypertension on the cerebral circulation. J Cereb Blood Flow Metab. 2018;38(12):2129-49.
26 Leonardi-Bee J, Bath PMW, Phillips SJ, Sandercock PAG. Blood pressure and clinical outcomes in the international stroke trial. Stroke. 2002;33(5):1315-20.
27 Wechsler LR, Roberts R, Furlan AJ, Higashida RT, Dillon W, Roberts H, et al. Factors influencing outcome and treatment effect in PROACT II. Stroke. 2003 Maio 1;34(5):1224-9.
28 Lima FO, Furie KL, Silva GS, Lev MH, Camargo EC, Singhal AB, et al. The pattern of leptomeningeal collaterals on CT angiography is a strong predictor of long-term functional outcome in stroke patients with large vessel intracranial occlusion. Stroke. 2010 Out 1;41(10):2316-22.
29 Kwah LK, Diong J. National Institutes of Health Stroke Scale (NIHSS). J Physiother. 2014 Mar;60(1):61.
30 Schlegel D, Kolb SJ, Luciano JM, Tovar JM, Cucchiara BL, Liebeskind DS, et al. Utility of the NIH stroke scale as a predictor of hospital disposition. Stroke. 2003 Jan 1;34(1):134-7.
Submetido em:
31/08/2023
Aceito em:
07/12/2023
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